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HomeMy WebLinkAboutACCO ENGINEERED SYSTEMS (5) A-2021-036-02 B MAYOR CITY MANAGER Valerie Amezcua yr Alvaro Nunez MAYOR PRO TEM CITY ATTORNEY Benjamin Vazquez Sonia R.Carvalhq COUNCILMEMBERS CITY CLERK Phil Bacerra .� Jennifer L. Hall Johnathan Ryan Hernandez — Jessie Lopez David Penaloza Thai Viet Phan CITY OF SANTA ANA iNSURAN,,_U�1 -,i_t WORK MAY t ROCLEC. PUBLIC WORKS AGENCY UNT1L d�SL R NEE tXPll{FC 20 Civic Center Plaza•P.O.Box 1988 T '0 Santa Ana,California 92702 CITY CLERK www.santa-ana.org DATE: APR 4 2025 March 11, 2025 ACCO Engineered Systems, Inc. 888 East Walnut St. Pasadena, CA 91101 Re: Second and Final Extension of Agreement A-2021-036-02 for Emergency ElVAC Repair Services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by ACCO Engineered Systems, Inc. ("Contractor") and the City of Santa Ana, dated March 16, 2021, the time period of the Agreement is hereby further extended for an additional one (1) year period until March 31,2026.Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sincerely, Nabil Saba,PE Executive Director, Public Works Agency CITZOFSA TA 71 ATTEST Alvaro Nunez Jennifer all City Manager Ci r �: APPROVED AS TO FORM CONTRACTOR Digitally signed by Adrian Menendez jf DN:C=l1S, Ky1t4 Nellesen By: Adrian Menendez_ E= I�leneMez@accoes.com, o="ACCO Engineered Systems Assistant City Attorney Title: OU=Sales Manager,CN=Adrian Menendez Date:2025.03.20 09:33:05-07'00' SANTA ANA CITY COUNCIL Valerie Amezcua Benjamin Vazquez Thai VEet Phan Jessie Lopez Phil Bacerra Johnalhan Ryan Hernandez David Penaloza Mayor Mayor Pro Tern,Ward 2 Ward 1 Ward 3 ward 4 Ward 5 Ward 6 vamemensanla-ana.ora bvazauezOsanta-ana.oro tpharr rf�r santa-ans.orp lessielopezzonla-ana.org pbacerra0santa-ana_om irvanhemandezCaZsanla-ana.orp dpenalozaCaYsanla-ana ere CERTIFICATE OF LIABILITY INSURANCE DATEI104120YYYY} D91D4Y2p24 N m THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 2 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED s REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of 1he policy,certain policies may require an endorsement,A statement on this w certificate does not cantor rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT 61 Aon Risk Insurance Services West, Inc. NAME: Z7PHONE (866) 283_7122 FAX (800) 361-DlOS LOS Angeles CA office (A/C.No.EXI): (AIC.No.): 707 Wilshire Boulevard E-MAIL c Suite 2600 ADDRESS: _ Los Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: LM Insurance Corporation 33600 ACCO Engineered Systems, Inc. INSURER B: Liberty Mutual Fire Ins Co 23035 898 East Walnut Street Pasadena CA 91101 USA INSURERC: American Fire & Casualty Co 24066 INSURER.: Ironshore specialty Insurance Company 2544S Angie Acevedo Digitally 590 y R� Pall parry 39462 I I I COVERAGE CERTIFICATE NIi;ABER: 570108013570 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR POLICY EFF POLICY FXP LTp TYPE OF INSURANCE INSD WV❑ POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS B X COMMERCIAL GENERALLL PDAIVAGIF TO REMISES Ea occurrence LIABILITY Y TB 7 5 EACH OCCURRENCE $2,000,000 CLAIMS-MADE J x OCCUR R N ED $1,000,000 u MED EXP(Any one person) $5,000 PERSONAL&ADV IIFlY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PERT GENERALAGGREGATE $4,000,000 F6 POLICY PRO LOG PRODUCTS-COMPICP AGG $4,000,000 O JECT OTHER: d n B AUTOMOBILE LIABILITY Y Y As2-661-067353-024 10/01/2024 10/01/2025 COMBINED SINGLE LIMIT 'n Ea accident) $5,000,000 X BODILY INJURY(Per person) O ANY AUTO Z OWNED SCHEDULE❑ BODILY INJURY(Per accident) y AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED U ONLY AUTOS ONLY Par accident Q} C UMBRELLA LIAB X OCCUR Y V EUA2563708SO2 10/01/2024 10/01/2025 EACH OCCURRENCE $5,000.000 0 X EXCESS LIAS CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION A WORKERS COMPENSATION AND Y WA566DO67353014 10/01/2024 10/01 2025 X PER STATUTE OTH- EMPLOYERS'LIABILITY YIN ER ANY PROPRILTOR 1 PAHTNER I EXECUTIVEE ll E.L.EACH ACCIDENT 11,000,000. OFFICER MEMBER EXCLUDED' N N/A (Mandatory in NH) L��� E.L.DISEASE-EAEMPLOYEF S1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS belaw E_L.DISEASE-POLICY LIMIT $1,000,000 E Environmental Contractors and Y PCADB50260631024 10/01/2024 10/01/2025 Aggregate/Each Lass $2,000,000 Prof Claims Made Prof Agg SIR $600,000 SIR applies per policy ter 1,, s & cordi ions Prof Each Claim SIR $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1111,Add4llonal Remarks Schedule,maybe attached If more space is required) [RE: Construction, All Operations.] [AI: City of Santa Ana, its officers, employees, agents and representatives] are included as Additional Insured with respect to the General Liability and Automobile Liability Policies; granted a Waiver of Subrogation for the General Liability, Automobile Liability, Professional Liability and workers' compensation Policies; and General Liability Policy evidenced herein is Primary and Non-Contributory to other insurance available as required by written contract but limited to the operations of the insured under the said contract. EXcess Liability is Follow Form. el CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. cityof Santa Ana AUTHORIZED REPRESENTATIVE Attn: Risk Management Division 20 Civic Center Plaza, 4th Floor A r Y �t DWim Santa Ana CA 92701 USA e f�1 pt �edcLt�?tgs eC/�6t ire REIAEWEO&APPROVEDft Risk Marlagement Specialist £01988-2015 ACORD CC ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TB2-661-067353-034 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 — Who is An Insured is amended to 1. All work, including materials, parts or equipment include as an additional insured the person(s) or furnished in connection with such work, on the organization(s) shown in the Schedule, but only project (other than service, maintenance or with respect to liability for "bodily injury", "property repairs) to be performed by or on behalf of the damage" or "personal and advertising injury" additional insured(s) at the location of the caused, in whole or in part, by: covered operations has been completed; or 1. Your acts or omissions; or 2. That portion of "your work" out of which the 2. The acts or omissions of those acting on your injury or damage arises has been put to its behalf; intended use by any person or organization other than another contractor or subcontractor in the performance of your ongoing operations for engaged in performing operations for a principal the additional insured(s) at the location(s) as a part of the same project. designated above. C. With respect to the insurance afforded to these However: additional insureds, the following is added to 1. The insurance afforded to such additional Section III—Limits Of Insurance: insured only applies to the extent permitted by If coverage provided to the additional insured is law; and required by a contract or agreement, the most we 2. If coverage provided to the additional insured is will pay on behalf of the additional insured is the required by a contract or agreement, the amount of insurance: insurance afforded to such additional insured 1. Required by the contract or agreement; or will not be broader than that which you are required by the contract or agreement to provide 2. Available under the applicable Limits of for such additional insured. insurance shown in the Declarations; B. With respect to the insurance afforded to these whichever is less. additional insureds, the following additional This endorsement shall not increase the applicable exclusions apply: Limits of Insurance shown in the Declarations. This insurance does not apply to "bodily injury" or "property damage" occurring after: 7771 RIAMmugen"Dtn [m REVIEWED&APPROVED BY. Risk Management sped dis4 CG 20 10 04 13 © ISO Properties, Inc., 2012 Page 1 of 2 13 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations All persons or organizations with whom you have entered All locations as required by a written contract or into a written contract or agreement, prior to an agreement entered into prior to an"occurrence"or "occurrence"or offense,to provide additional insured status. offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Rude Manqentmt l7ndat. �IEW/ ED&APPRovED 8Y: f'1'�rIG�N�U A M Rick Management Speaalfst CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER: TB2-661-067353-034 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations with whom you have Aii locations as required by a written contract or agreement entered into a written contract or agreement, prior to an entered into prior to an "occurrence" or offense. "occurrence"or offense, to provide additional insured status Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to Risk M2nogonadDiHsim provide for such additional insured. 3: _ + nobarPr®By ilk A qu Aa4v44 Risk ManagementSpedaiist LOF CG 20 37 04 13 ® Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:TB2-661-067353-034 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the"products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule below. SCHEDULE Name Of Person Or Organization: As required by written contract or agreement entered into prior to foss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, Kil_ Rule Msmagentenf t?ivisim 0 x REVIEWED&APPROVED 8r {�ceueefa _- v Risk ManagementSpeocdist `- CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: AS2-661-067353-024 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the"accident" or the "loss" under a contract with that person or organization. -- Risk MwwgemadElMsian t RmAEwm&APPROvBD BY: �1r�li�l��L �►�+a�laaVesdn '�--�-� Risk Management Specialist CA 04 44 10 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2-661-067353-024 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement, This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s)Or Organization(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. �1I1LL` A &4V44 —� Risk Management Specialist CA 20 48 10 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER!TB2-661-067353-034 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and Risk Manogawnt Division 3; RWEWEQ&APPROVED SY _ �" 1Q�rgGZves�o CG2001 0413 O Insurance Services Office, Inc.,2012 ® Risk Managementspeawist ,V; Policy Number TB2-661-067353-034 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR MATERIAL REDUCTION IN COVERAGE TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY— UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)1 Email Address or mailing address: Number Days Notice: Or anization s : Per schedule on file with broker Per schedule on file with broker 30 days A. If we cancel this policy for any reason other than nonpayment of premium, or make a material reduction in coverage, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation or material reduction of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. Rialt MmagententDwion 4r REVEWED&APPRoveD BY: t IM 99 04 03 14 O 2014 Liberty Mutual Insurance.All rights reserved. i Includes copyrighted material of Insurance Services Office, Inc.,with its err ! p Risk Managementspea list Policy Number: AS2-661-067353-024 Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY— UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)1 Email Address: Organ ization s : Per schedule on file with broker A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above by email as soon as practical after notifying the first Named Insured. B. This advance email notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. „� ltiskMan�,gerrtenf ihwsan LIM 99 02 08 11 ©2011 Liberty Mutual Group of Companies. All rights reservE 3,' REVIEWED&APPROVED BY, Includes copyrighted material of Insurance Services Office, Inc., ' I e A'tV44 Its permission. Risk Management5pedAift THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES A. if we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name of Other Person(s)f Email Address or mailing address: Number Days Notice: Organization(s): Per schedule on file with broker Per schedule on file with broker 30 days All other terms and conditions of this pollcy remain unchanged. Issued by LM Insurance Corp. For attachment to Policy No. WA5-66D-067353-014 Effective Date 10/01/2024 Premium$ Issued to Rule MWWgMU7d Division 3 c REmEwED&APPRDVH3 By. WM 90 18 06 11 c0 2011 Liberty Mutual Group of Companies Risk Management SpeciAist Ed. 06/01/2011 All Rights Reserved WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Where required by contract or written agreement prior to loss and allowed by law. Issued by: LM Insurance Corp. For attachment to Policy No WA5-66D-067353-014 Effective Date 10/01/2024 Premium Issued to: ACCQ Engineered Systems, Inc. RiskManagentmt Dwim j REmEWED&APPROVED BY. �y RisktvmanageinentSped4st WC 00 03 13 O 1983 National Council on Compensation Insurance, Inc. Ed. 4/1/1984 Coverage Is Provided In. Policy Number: L1bCrty American Fire and Casualty Company -a stock company EUA(25)63 70 85 02 Mutual. INSURANCE (ITEM 5)SCHEDULE OF UNDERLYING INSURANCE: CARRIER, POLICY NUMBER AND PERIOD TYPE OF COVERAGE LIMITS OF INSURANCE FIRST UNDERLYING INSURANCE GENERAL $2,000,000 EACH OCCURRENCE LIBERTY MUTUAL FIRE INSURANCE LIABILITY LIMIT COMPANY S2,000,000 PERSONAL AND T132-661-067353-034 ADVERTISING INJURY 10/01/2024 - 10/01/2025 LIMIT $4,000,000 GENERAL AGGREGATE LIMIT $4,000,000 PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT FIRST UNDERLYING INSURANCE OWNED AND HIRED $5,000,000 COMBINED SINGLE LIBERTY MUTUAL FIRE INSURANCE AND/OR NONOWNED LIMIT COMPANY AUTO LIABILITYY AS2-661-067353-024 10/01/2024 - 10/01/2025 FIRST UNDERLYING INSURANCE EMPLOYERS $1,000,000 BODILY INJURY EACH LM INSURANCE CORPORATION LIABILITY* ACCIDENT LIMIT $1,000,000 BODILY INJURY BY WA5-66D-067353-014 DISEASE AGGREGATE 10/01/2024 - 10/01/2025 LIMIT $1,000,000 BODILY INJURY BY DISEASE EACH EMPLOYEE LIMIT s *EMPLOYERS LIABILITY COVERAGE IS NOT PROVIDED FOR CLAIMS BY EMPLOYEES WHO ARE SUBJECT TO THE WORKERS COMPENSATION LAWS OF NEW YORK FIRST UNDERLYING INSURANCE EMPLOYEE $1,000,000 EACH EMPLOYEE LIMIT LIBERTY MUTUAL FIRE INSURANCE BENEFITS COMPANY LIABILITY $2,000,000 AGGREGATE LIMIT TB2-661-067353-034 10/01/2024 -10/01/2025 ,:_.-•MGf "MougementDb6inn q�F� VIEWED&APPROVEDBY:. : To report a claim, call yourAgent or 1-8¢¢-325-2¢57 ' RNk Management Specialist DS70230108 0912a/22 637M502 POLSVCS 275 NCAFPPNO INSURED COPY 003179 PAGE 26 CF 0 Coverage Is Provided In: Policy Number: L.lbGrty American Fire and Casualty Comoanu -a stock company EUA (25) 63 70$5 02 Mutual. INSURANCE (ITEM 5)SCHEDULE OF UNDERLYING INSURANCE: -CONTINUED CARRIER, POLICY NUMBER AND PERIOD TYPE OF COVERAGE LIMITS OF INSURANCE FIRST UNDERLYING INSURANCE OTHER LIABILITY $25,000,000 EACH OCCURANCE STARR INDEMNITY & LIABILITY TYPE: NON-OWNED COMPANY AIRCRAFT LIABILITY 1000226321-09 t0/01/2024 - 10/01/2025 N =R Risk MmagmuntWslm iREVfEWED&APPROVE)BY �1111 1' Ate:¢Aavdo . Risk Management Spedallst To report a claim, call your Agent or 1-644-325-2467 DS 70 23 01 08 09/28122 63708502 POLSVCS 275 NCAFPPNO INSURED COPY 003179 PAGE 27 OF 50 CE 65 24 06 97 EXCESS LIABILITY COVERAGE FORM There are provisions in this policy that restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured. The words "we," us" and "our" refer to the Company providing this insurance. The word Insured means any person or organization qualifying as such in the "first underlying insurance." Other words and phrases that appear in quotation marks have special meaning and can be found in the DEFINITIONS Section or the specific policy provision where they appear. In consideration of the payment of the premium and in reliance upon the statements in the Declarations we agree with you to provide the coverage as follows: INSURING AGREEMENTS I. COVERAGE of the Declarations is the most we will pay for all "loss" that is subject to an We will pay on behalf of the Insured the aggregate limit provided by the "first amount of "loss" covered by this insurance in underlying insurance." The aggregate excess of the "Underlying Limits of Insurance" limit applies separately and in the shown in Item 5. of the Declaratbns, subject same manner as the aggregate limits to INSURING AGREEMENT Section I1., Limits provided by the "first underlying insur- of Insurance. Except for the terms, conditions, ante," provided that all "underlying in- definitions and exclusions of this policy, the surance" applies their aggregate limit coverage provided by this policy will follow in the same manner as the "first un- the "first underlying insurance." derlying insurance." IL LIMITS OF INSURANCE 3. Subject to B,2., the occurrence limit stated in Item 4, of the Declarations is A. The Limits of Insurance shown in the Dec- the most we will pay for ail "loss" larations and the rules below describe the arising out of any one occurrence to most we will pay under the terms of this which this policy applies. insurance regardless of the number of: 4. Subject to Paragraphs B.2. and 8.3. 1. Insureds; above, if the "Underlying Limits of In- surance" described in Item 5. of the 2, claims made or suits brought; Declarations are either reduced or ex- 3. persons or organizations making hausted solely by payment of "loss," claims or bringing suits. such insurance provided by this policy will apply in excess of the reduced B. The Limits of Insurance of this policy will underlying limit or, if all underlying apply as follows: limits are exhausted, will apply as "un- derlying insurance" subject to the 1. This policy applies only in excess of same terms, conditions, definitions and the "Underlying Limits of Insurance" exclusions of the "first underlying in- shown in Item 5. of the Declarations. surance," except for the terms, condi- tions, definitions and exclusions of this 2. The aggregate limit shown in Item 4. policy. Rude Msm pm oet Division RDAEWED&APPROVEDBY. A �A -- -► czv44 Risk Management Spedc9ist CE 65 24 06 97 (Page 1 of 7) ducts, asbestos-containing materials or However, we will not pay that portion products, asbestos fibers or asbestos of a "loss" that is within the "Under- dust; or lying Limits of Insurance" which the Insured has agreed to fund by self- 3. any obligation to investigate, settle or insurance or means other than insur- defend, or indemnify any person ante. against any claim or suit arising out of or related in any way, either directly or 5. The limits of this policy apply sepa- indirectly, to asbestos, asbestos pro- rately to each consecutive annual pe- ducts, asbestos-containing materials or riod, and to any remaining period of products, asbestos fibers or asbestos less than 12 months, starting with the dust. beginning of the policy period shown in the Declarations unless the policy B. Any liability, including, but not limited to period is extended after issuance for settlements, judgments, costs, charges, ex- an additional period of less than 12 penses, costs of investigations, or the fees months. In that case the additional pe- of attorneys, experts, or consultants aris- riod will be deemed part of the last ing out of or in any way related to: preceding period for purposes of deter- mining the Limits of Insurance. 1. the actual, alleged or threatened pres- ence, discharge, dispersal, seepage, Ill. DEFENSE migration, release or escape of "pollu- tants," however caused; A. We will not be required to assume charge of the investigation of any claim or de- 2. any request, demand, or order that any fense of any suit against you. Insured or others test for, monitor, clean up, remove, contain, treat, de- B. We will have the right, but not the duty, to toxify, neutralize or in any way re- be associated with you or your underlying spond to or assess the effects of "pol- insurer or both in the investigation of any lutants." This includes demands, direc- cWrn or defense of any suit which in our tives, complaints, suits, orders or re- opinion may create liability on us for quests brought by any governmental "loss." If we exercise such right, we will entity or by any person or group of do so at our own expense, but not after persons; the limits of this policy are exhausted. 3. steps taken or amounts incurred by a IV. EXCLUSIONS governmental unit or any other person or organization to test for, monitor, This policy does not apply to: clean-up, remove, contain, treat, de- toxify or neutralize or assess the ef- A. Any liability, including, but not limited to fects of "pollutants." settlements, judgments, costs, charges, ex- penses, costs of investigations, or the fees This exclusion will apply to any liability, 4 of attorneys, experts, or consultants arls- costs, charges or expenses, or any judg- ing out of or related in any way, either ments or settlements, arising directly or directly or indirectly, to: indirectly out of pollution whether or not the pollution was sudden, accidental, grad- 1. asbestos, asbestos products, asbestos- ual, intended, expected, unexpected, pre- containing materials or products, as- ventable or not preventable. bestos fibers or asbestos dust, includ- ing, but not limited to, manufacture, As used in this exclusion "pollutants" mining, use, sale, installation, removal, means any solid, liquid, gaseous or ther- or distribution activities; mal irritant or contaminant, including, but not limited to, smoke, vapor, soot, fumes, 2. exposure to testing for, monitoring of, acids, alkalis, chemicals and waste ma- cleaning up, removing, containing or terial. treating of asbestos, asbestos pro- 33 RWEWM&APPRovED3 8Y . Z A AIZV44 Risk Management Spedalist °= CE 65 24 06 97 (Page 2 of 7) Waste material includes materials which such "underlying insurance," but will sp- are intended to be or have been to be ply as if the "underlying insurance" was recycled, reconditioned or reclaimed. available and collectible. C. Any liability excluded by the Nuclear En- C. Changes ergy Liability Exclusion attached to this policy. Notice to any agent or knowledge pos- sessed by any agent or any other person V. DEFINITIONS will not effect a waiver or change in any part of this policy. This policy can only be A. "First underlying insurance" means the changed by a written endorsement that policy or policies of insurance stated as becomes a part of this policy and that is such in Item 5. of the Declarations. signed by one of our authorized repre- sentatives. B. "Loss" means those sums actually paid in the settlement or satisfaction of a claim D. Cancellation which you are legally obligated to pay as damages after making proper deductions 1. You may cancel this policy. You must for all recoveries and salvage. mail or deliver advance written notice to us stating when the cancellation is C. "Underlying insurance" means "first un- to take effect. derlying insurance" and all policies of in- surance listed in Item 5. of the Declara- 2. We may cancel this policy. If we cancel tions. because of nonpayment of premium, we must mail or deliver to you not less D. "Underlying Limits of Insurance" means than ten (10) days advance written no- the total sum of the limits of all applicable tice stating when the cancellation is to "underlying insurance" stated in Item 5. of take effect. If we cancel for any other the Declarations, including self-insurance, reason, we must mail or deliver to you or means other than insurance. not less than thirty (30) days advance written notice stating when the can- VI. CONDITIONS cellation is to take effect. Mailing that notice to you at your mailing address A. Appeals shown in Item 1. of the Declarations In the event you or any underlying insurer will be sufficient to prove notice. elects not to appeal a judgment in excess 3. The policy period will end on the day of the amount of the "Underlying Limits of and hour stated in the cancellation no- Insurance," we may elect to appeal at our tire. expense. If we do so elect, we will be liable for the costs and interest incidental 4. If we cancel, final premium will be cal- to this appeal. In no event will this provi- culated pro rats based on the time this sion increase our liability beyond the ap- policy was in force. pliicable Limits of Insurance described in Section II. of this policy. 5. if you cancel, final premium will be more than pro rat@; it will be based on B. Bankruptcy or Insolvency the time this policy was in force and increased by our short rate cancellation The bankruptcy, insolvency or inability to table and procedure. pay of any Insured or the bankruptcy, in- solvency or inability to pay of any of the 6. Premium adjustment may be made at underlying insurers will not relieve us the time of cancellation or as soon as from the payment of any claim or suit practicable thereafter but the cancella- covered by this policy, tion will be effective even if we have not made or offered any refund due In the event of bankruptcy or insolvency of you. Our check or our representative's any underlying Insurer, the insurance af- forded by this policy will not replace REVIEWED&APFKNED BY' Risk Managernent Specialist CE 65 24 06 97 (Page 3 of 7) check, mailed or delivered, will be suf- ficient tender of any refund due you. 1. to keep the policies listed in Item 5. of the Declarations in full force and ef- 7. The first Named Insured in Item 1. of fect; the Declarations will act on behalf of all other Insureds with respect to the 2. that the Limits of Insurance of the "un- giving and receiving of notice of can- derlying insurance" policies listed in cellation and the receipt of any refund Item 5. of the Declarations will be that may become payable under this maintained except for any reduction or policy. exhaustion of aggregate limits by pay- ment of claims or suits for 'losses" 8. Any of these provisions that conflict covered by "underlying insurance." with a law that controls the cancella- tion of the insurance in this policy is If you fail to comply with these require- changed by this statement to comply ments, we will only be liable to the same with the law. extent that we would have been had you fully complied with these requirements. E. First Named Insured Duties H. Notice of Occurrence The person or organization first named in Item 1. of the Declarations is responsible 1. You must see to it that we are notified for the payment of all premiums. The first as soon as practicable of an occur- Named Insured will act on behalf of all rence which may result in a claim or other Named Insureds for the giving and suit which may involve this policy. To receiving of notice of cancellation or the the extent possible, notice will include: receipt of any return premium that may become payable. a. how, when and where the occur- rence took place; We will be furnished a complete copy of the "first underlying insurance" described b. the names and addresses of any in Item 5. of the Declarations and any injured persons and witnesses; subsequently issued endorsements which c. the nature and location of any in- may in any way affect this insurance. jury or damage arising out of the F. Legal Actions Against Us occurrence. There wiH be no right of action against us 2. If a claim or suit against any Insured is under this insurance unless: reasonably likely to involve this policy you must notify us in writing as soon 1. you have complied with all the terms as practicable. of this policy; and 3. You and any other involved Insured 2, the amount you owe has been deter- must: mined by settlement with our consent or by actual trial and final judgment. a. immediately send us copies of any demands, notices, summons- This insurance does not give anyone the es or legal papers received in con- right to add us as a party in an action nection with the claim or suit; x against you to determine your liability. b. authorize us to obtain records and G. Maintenance of Underlying Insurance other information; During the period of this policy, you agree: G. cooperate with us in the inves- tigation, settlement or defense of the claim or suit; and d. assist us, upon our request, in the enforcemen' do any person oa,s RiAMaagartaiEt]ivi Wn 9 REWEWSD&APPROVE)8Y c. s Rak Management Specialist CE 65 24 06 97 (Page 4 of 7) may be liable to the Insured be- additional premium charge is made to the cause of injury or damage to "underlying insurance" during the policy which this insurance may also ap- period or if there is an increase in the risk ply. assumed by us, our premium may be ad- justed accordingly. 4. If the "Underlying 'Limits of Insurance" are exhausted solely by payment of "loss," no Insured will, except at their K. Terms Conformed to Statute own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, with- The terms of this policy which are in con- out our consent. flirt with the statutes of the state where this policy is issued are amended to con- I. Other Insurance form to such statutes. If other insurance applies to a "loss" that is also covered by this policy, this policy If we are prevented by law or statute from will apply excess of the other insurance. paying on behalf of the Insured, then we Nothing herein will be construed to make will, where permitted by law or statute, this policy subject to the terms, conditions indemnify the Insured. and limitations of such other insurance. However, this provision will not apply if the other insurance is specifically written L. When "Loss" is Payable to be excess of this policy. Other insurance includes any type of self- Coverage under this policy will not apply insurance or other mechanism by which unless and until the Insured or the In- an Insured arranges for funding of legal sured's "underlying insurance" is obligat- liabilities. ed to pay the full amount of the "Under- " lying Limits of Insurance." J. Premium Unless otherwise provided, the premium When the amount of "loss" has finally for this policy is a flat premium and is not been determined, we will promptly pay on subject to adjustment except as provided behalf of the Insured the amount of "loss" herein or amended by endorsement. If any falling within the terms of this policy. NUCLEAR ENERGY LIABILITY EXCLUSION This policy does not apply to: 2. resulting from the "hazardous properties" A. Any liability, injury or damage: of "nuclear material" and with respect to which (a) a person or organization is re- 1, with respect to which any Insured under quired to maintain financial protection pur- the policy is also an Insured under a nu- suant to the Atomic Energy Act of 1954, or clear energy liability policy issued by Nu- any law amendatory thereof, or (b) any clear Energy Liability Insurance Associ- Insured is, or had this policy not been afon, Mutual Atomic, Energy Liability Un- issued would be, entitled to indemnity derwriters, Nuclear Insurance Association from the United States of America, or any of Canada or any of their successors, or agency thereof, under any agreement en- would be an Insured under any such policy tered into by the United States of America, but for its termination upon exhaustion of or any agency thereof, with any person or its Limits of Insurance; or organization. __ RA Mwwgement Division 3: '0Wr3 4 R AEWEQ&APPRov®8Y ° A e AL�va�La Risk Management Specudist CE 65 24 06 97 (Page 5 of 7) consists of or contains more than 25 B. Any injury or "nuclear property damage" re- grams of plutonium or uranium 233 or sulting from the "Hazardous properties" of any combination thereof, or more than "nuclear material," if: 250 grams of uranium 235; 1. the "nuclear material' (a) is at any "nu- d. any structure, basin, excavation, prem- clear facility" owned by, or operated by or ises or place prepared or used for the on behalf of, any Insured or (b) has been storage or disposal of, "nuclear discharged or dispersed therefrom; waste," and includes the site on which any of the foregoing is located, all op- t. the "nuclear material" is contained in erations considered on such site and "spent fuel" or "nuclear waste" at any all premises used for such operations. time possessed, handled, used, processed, stored, transported or disposed of by or on 3. "Nuclear material" means "source mate- behalf of any Insured; or rial," "special nuclear material" or by- product material. 3. the injury or "nuclear property damage" arises out of the furnishing by any Insured 4. "Nuclear property damage" includes all of services, materials, parts of equipment forms of radioactive contamination of in connection with the planning, construc- property. tion, maintenance, operation or use of any "nuclear facility," but if such facility is lo- 5. "Nuclear reactor" means any apparatus cated within the United States of America, designed or used to sustain nuclear fission its territories or possessions or Canada, in a self-supporting chain reaction or to this Exclusion B.3. applies only to "nuclear contain a critical mass of fissionable ma- property damage" to such "nuclear facili- terial. ty" and any property therein. 6. "Nuclear waste" means any "nuclear C. As used in this exclusion: waste" material (a) containing "by-product material" other than the tailings of "nu- 1. "Hazardous properties" includes radioac- clear waste" produced by the extraction or tive, toxic or explosive properties. concentration of uranium or thorium from any ore processed primarily for its "source 2. "Nuclear facility" means: material" content, and (b) resulting from the operation by any person or organiza- a, any "nuclear reactor"; Lion of any "nuclear facility" included with- b. any equipment or device designed or in the definition of "nuclear facility" under used for Paragraph C.2.a. or C.2.1b. 7. "Source material," "special nuclear mate- (1) separating the isotopes of urani- rial," and "by-product material" have the um or plutonium, meanings given them in the Atomic En- (2) processing or utilizing "spent ergy Act of 1954 or in any law amendatory fuel" or thereof. (3) handling, processing or packaging 8. "Spent fuel" means any fuel element or "'nuclear waste"; fuel component, solid or liquid, which has been used or exposed to radiation in a c. any equipment or device used for the "nuclear reactor." processing, fabricating or alloying of"special nuclear material" if at any This endorsement does not change any other time the total amount of such material provision of the policy. in the custody of any Insured at the premises where such equipment or de- vice is located RIA Mmg...t Division RPAEWED&APPROVED BY. A*�4 ktv44 Risk Management Specialist CE 65 24 06 97 (Page 6 of 7) Policy No.PCADB-5026063-1024 Page 17of 19 2. any act,error, omission or Pollution Condition asserted or believed to be at issue; 3. the services or activities involved in the circumstance; 4. what happened and the dates and entities involved;and 5. the nature of any alleged or potential Loss; then any Claim or First Party Claim arising out of such circumstance shall be deemed to have been made on the date we received the written report of the circumstance. At our sale discretion and cost,we may elect to investigate any circumstance which is reported; any such costs associated with the investigation of a circumstance prior to a Claim being made against you will not be considered Claim Expense, will not reduce the applicable Self-Insured Retention and shall be paid by us in addition to the Limit of Liability XI. CONDITIONS A. Territory The coverage afforded by this Policy applies worldwide. B. Audit and Inspection Upon reasonable prior notice,we shall be permitted to audit your final books and records at any time during the Policy Period, the Automatic Extended Reporting Period, the Optional Extended Reporting Period, if applicable, and within three years after the final termination of this Policy, as far as they relate to the subject matter of this Policy. We shall also be permitted to inspect, sample, and/or monitor your operations on a continuing basis. Neither our right to make inspections, sample, and/or monitor, nor the actual undertaking thereof, nor any report thereon shall constitute an undertaking, on behalf of us or others, to determine or warrant that your operations are safe, healthful,conform to acceptable practice, or are in compliance with any law,rule,or regulation. C. Subrogation In the event of any payment under this Policy,we shall be subrogated to all of your rights of recovery thereof. You shall execute and deliver all requested instruments and papers in furtherance of such rights to us and do whatever else is reasonably necessary to secure such rights. You shall do nothing to waive or prejudice such rights. We shall have priority in any recovery, and any amounts recovered in excess of our total payment and the cost to us of recovery shall be paid to you. However,we waive our rights of subrogation under this Policy against your clients or their designees (except for a Responsible Entity)to the extent such a waiver is required by a written contract with you executed prior to the Claim. For Coverage A only,we will not subrogate against a Responsible Entity in excess of its collectible insurance, provided it has maintained Recoverable Insurance, regardless of whether or not such Recoverable Insurance is exhausted or reduced. D. Changes None of the provisions of this Policy will be waived, changed, or modified except by written endorsement issued by us to form a part of this Policy. Notice to any of our agents or knowledge possessed by any such agent or any other person will not act as a waiver or change in any part of this Policy and will not prevent us from asserting any rights under the provisions of this Policy. E. Action Against Us Only you can make claims against us under Coverages A and F,and the Supplemental Coverages, of this Policy. No action shall be taken against us with respect to Coverage A unless, as a condition precedent thereto, you shall have fully complied with 0 the terms of this Policy, and until the amount the Responsible Entity is legally obligated to pay shall have been finally determined either by judgment after actual contested trial or arbitration, or other method of dispute resolution for which we have given prior writtl Risk Mwagenent DM ion REVIEWED&APPROVER BY. Policy Form:PERFORM-10001 (05.16) Ri k t:i�na9einentSpee�list